| NPI | 1538465448 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: GA PTA003691) | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE006566) | 
| Enumeration Date | 2011-02-10 | 
| Last Update Date | 2019-03-28 |