| NPI | 1225317720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA TEI001974) |
| Additional Taxonomies | 224L00000X (Licence: PA 1127) |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2011-08-15 |