| NPI | 1649728833 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA21040) | 
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL PTA21040) | 
| Enumeration Date | 2016-09-15 | 
| Last Update Date | 2020-12-16 |