| NPI | 1164547469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CA AT 3216) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 089102404) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |