| NPI | 1194298604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 09649) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 49054) |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2019-01-08 |