| NPI | 1942595889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 09465) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WY 0977) |
| 225200000X Physical Therapy Assistant (Licence: CT 001096) | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2021-08-31 |