| NPI | 1255542445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: RI PT00704) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: RI AT00102) |
| Enumeration Date | 2007-05-27 |
| Last Update Date | 2007-07-08 |