| NPI | 1932579844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MI 5502008763) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI L2602664) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2026-04-01 |