| NPI | 1649552241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 22900) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: GA PTA002232) |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2021-12-03 |