| NPI | 1235495243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT02391) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 009130) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: RI AT00272) | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2018-01-08 |