| NPI | 1134859689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 4149) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CO 0015058) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2024-12-24 |