| NPI | 1386772101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 599-019) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 262-039) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2023-05-31 |