| NPI | 1962095190 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2096400)  | 
| Enumeration Date | 2021-02-18 | 
| Last Update Date | 2021-02-18 |