| NPI | 1063788156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2117739) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 1857-19) |
| 225200000X Physical Therapy Assistant (Licence: MN A1489) | |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2018-08-16 |