| NPI | 1417337312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT03307) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 14.010038) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2020-08-27 |