| NPI | 1114159100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NC 3719) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2070555) |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2009-08-10 |