| NPI | 1013316405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NE 666) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS 14-01635) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |