| NPI | 1043793391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: 81666) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IL 160.008154) |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2024-12-11 |