| NPI | 1669123444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA TE008720) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MA 9978) |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2022-01-13 |