| NPI | 1508512906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MA PTA9848) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 010630) |
| Enumeration Date | 2022-02-23 |
| Last Update Date | 2023-09-12 |