| NPI | 1205213311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 25441) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KY A04036) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2019-08-01 |