| NPI | 1164767521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 08887) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 9632) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2012-12-11 |