| NPI | 1659403640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 11188) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: RI PT01708) |
| 225100000X Physical Therapist (Licence: ME PT3250) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2007-07-08 |