| NPI | 1548505969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MA 8404) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NH 1031) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2012-12-11 |