| NPI | 1629192554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NE 252) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IA 00295) |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2007-07-08 |