| NPI | 1780458216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA TE1002655) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA TE1002655) |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2023-11-15 |