| NPI | 1578961850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MO 114993) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS 1401731) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |