| NPI | 1104208024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: VA 2306602773) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2014037317) |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2015-06-27 |