| NPI | 1790994168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT01119) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 11033) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2008-03-31 |