| NPI | 1255763793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI 02615) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 4030) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2018-04-12 |