| NPI | 1770123499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT03194) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 24385) |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2020-01-10 |