| NPI | 1376916718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: SD 0459) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NE 1254) |
| Enumeration Date | 2015-11-06 |
| Last Update Date | 2022-12-31 |