| NPI | 1720571276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AZ 8368A) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: AZ 8368A) |
| Enumeration Date | 2018-06-10 |
| Last Update Date | 2018-06-10 |