| NPI | 1184070997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2167050) |
| 225200000X Physical Therapy Assistant (Licence: FL 26913) | |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2022-01-12 |