| NPI | 1962672832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: GA 003698) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: SC 3418) |
| 225200000X Physical Therapy Assistant (Licence: NC A3950) | |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2018-03-17 |