| NPI | 1639318926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 18339) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: RI PT2180) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2015-04-21 |