| NPI | 1033448154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: SC 3144) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: VA 0126000486) |
| 225200000X Physical Therapy Assistant (Licence: VA 2306602864) | |
| Enumeration Date | 2009-12-19 |
| Last Update Date | 2014-05-19 |