| NPI | 1568733517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: RI 00675) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: MA 8564) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2021-07-19 |