| NPI | 1972136406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 044646) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: RI PT03255) |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2020-02-14 |