| NPI | 1699361824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT01540) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CT 006432) |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: CT 006432) | |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2025-08-07 |