| NPI | 1770163875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA TEI005813) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 007099-01) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2021-04-12 |