| NPI | 1144352089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: LA PTA1983) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 000090406) |
| 174400000X Specialist (Licence: LA J00065) | |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2015-09-23 |