| NPI | 1376137406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MT PTP-PTA-LIC-19451) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT PTP-PTA-LIC-19451) |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2022-03-30 |