| NPI | 1306109582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: PA TE1002166) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2024-09-30 |