| NPI | 1164035911 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 3087-19)  | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant | 
| Enumeration Date | 2020-08-30 | 
| Last Update Date | 2020-09-10 |