| NPI | 1154527414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NE 933) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WY PTA 405) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2013-07-17 |