| NPI | 1811588874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2053876) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX 2053876) |
| Enumeration Date | 2021-02-01 |
| Last Update Date | 2021-02-04 |