| NPI | 1801331780 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2175395) | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MS PTA6022) | 
| Enumeration Date | 2016-12-30 | 
| Last Update Date | 2024-03-22 |