| NPI | 1790556074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MO 2019039797) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OK 3159) |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-01-15 |