| NPI | 1861563454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: RI 00233) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MA 2656) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |