| NPI | 1467091470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MS 6560) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TN 6744) |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2020-01-02 |