| NPI | 1649689134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CT 2039) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: SD 0347) |
| 225200000X Physical Therapy Assistant (Licence: MN A1610) | |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2020-01-29 |