| NPI | 1902351554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225CX0006X (Licence: MT CP017255A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KY A03497) |
| 225200000X Physical Therapy Assistant (Licence: CA 49591) | |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2023-03-17 |