| NPI | 1255711883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: RI PT00404) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: RI PTA00404) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2019-10-29 |