| NPI | 1770055956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: VA 2306605182) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MD A5025) |
| Enumeration Date | 2018-12-27 |
| Last Update Date | 2021-04-07 |