| NPI | 1245638576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2045987) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 2045987) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2023-04-17 |