| NPI | 1851758817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: LA A9100) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: LA ATH.200249) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |