| NPI | 1518494749 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WA A160245265) | 
| Enumeration Date | 2017-05-18 | 
| Last Update Date | 2021-06-08 |