| NPI | 1689129256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MA 8893) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CT 001661) |
| 225200000X Physical Therapy Assistant (Licence: SC 1809) | |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-08-23 |