| NPI | 1558016600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA 046691A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VA 2306606051) |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2026-01-15 |