| NPI | 1881113017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IA 098876) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 075210) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2020-05-21 |