| NPI | 1538411095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2102651) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MI 5502003509) |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2018-09-04 |