| NPI | 1316490659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MA 9040) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TN 6179) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-03 |