| NPI | 1104173277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL88617) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: RI PT02513) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2025-07-17 |