| NPI | 1114044971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 8244) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WA P160334499) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2007-03-24 |
| Last Update Date | 2019-06-20 |