| NPI | 1770006546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NC 6310) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD a4943) |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2019-08-23 |