| NPI | 1497131965 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT02862) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21799) | 
| Enumeration Date | 2015-08-06 | 
| Last Update Date | 2015-10-07 |