| NPI | 1558844696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: VA 2306603186) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: SC 3400) |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2021-12-15 |