| NPI | 1174066757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NC A5483) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: SC 3258) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |