| NPI | 1366995649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT00836) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 8112) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-03 |