| NPI | 1013519479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 3107-19) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2020-11-11 |
| Last Update Date | 2022-04-28 |