| NPI | 1356049845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: VA 2306605900) |
| Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports (Licence: VA 2306605900) |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2023-02-23 |