| NPI | 1265678288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MA #142) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: RI #PTA00141) |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2019-05-06 |