| NPI | 1235501735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CT 000747) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: RI PTA00184) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-22 |