| NPI | 1205062908 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 24110)  | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: GA 002403)  | 
| Enumeration Date | 2009-06-08 | 
| Last Update Date | 2017-02-28 |