| NPI | 1225469786 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 24125)  | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: GA Pta003156)  | 
| 225200000X Physical Therapy Assistant (Licence: AL 1552)  | |
| Enumeration Date | 2013-12-10 | 
| Last Update Date | 2014-03-19 |