| NPI | 1811549744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: VA 2306601294) |
| Additional Taxonomies | 171W00000X Contractor |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2020-12-03 |