| NPI | 1629193297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MA 2958) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: RI PTA00300) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2007-07-08 |