| NPI | 1477598654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MD A3409) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE06693) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT003411) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2010-08-26 |