| NPI | 1265948277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MO 2017041024) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS 14-03321) |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2017-12-28 |