| NPI | 1760977680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: HI 117) |
| Additional Taxonomies | 246Q00000X Spec/Tech, Pathology |
| Enumeration Date | 2018-06-23 |
| Last Update Date | 2019-03-13 |