| NPI | 1164903191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: 2048371) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2048317) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |