| NPI | 1275904062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WA 60540165) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 2242-19) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2016-02-10 |