| NPI | 1215095476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 1275-019) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 605-039) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2010-07-12 |