| NPI | 1275926602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: GA 003303) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL 34273) |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2026-05-21 |