| NPI | 1912321738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WV 25064) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL 24235) |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2015-05-19 |