| NPI | 1902176654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CO 12569) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH 07069) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2014-08-27 |