| NPI | 1992868947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 17788) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: RI PT01829) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2008-09-22 |