| NPI | 1760736391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: ME PT4016) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MA 8505) |
| 225200000X Physical Therapy Assistant (Licence: NH 0970) | |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2012-11-05 |