| NPI | 1184106577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OK 2834) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX 2134721) |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2021-08-23 |