| NPI | 1619402351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2120608) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 2410) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |