| NPI | 1114467073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 09497) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MT PTP-PTA-LIC-11326) |
| Enumeration Date | 2017-02-26 |
| Last Update Date | 2019-10-23 |