| NPI | 1619790847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MO 2021024907) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: MO 2021024907) |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2024-11-05 |