| NPI | 1639658370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA TE009942) |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: PA OF000220) |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-08-13 |