| NPI | 1558669069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X (Licence: VA A-3815120) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VA 2306601986) |
| Enumeration Date | 2011-03-08 |
| Last Update Date | 2024-01-22 |