| NPI | 1588096002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WY 0794) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VT 0410052734) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2013-08-07 |