| NPI | 1780815530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT02880) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 20591) |
| 225200000X Physical Therapy Assistant (Licence: MA 7983) | |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2020-07-13 |