| NPI | 1477807709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA27190) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL MA66895) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2021-09-16 |