| NPI | 1730263815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: RI RI943) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: RI 943) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: RI 943) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2023-09-22 |