| NPI | 1083212971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WA 60685837) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE011033) |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2020-10-13 |