| NPI | 1932590767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MA 3495) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: RI PTA0051) |
| 225200000X Physical Therapy Assistant (Licence: OR 08313) | |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2015-02-16 |