| NPI | 1104071141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AZ 12275A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: ME PA3319) |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2023-09-11 |