| NPI | 1154368314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT01004) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 006650) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2013-09-24 |