| NPI | 1972662765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT01260) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 4989) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2007-07-08 |