| NPI | 1538648647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 21343) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 11031664) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2024-03-10 |