| NPI | 1205218195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2135430) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AZ 11627A) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2021-01-25 |