| NPI | 1568840700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 09598) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AZ 11422A) |
| 225200000X Physical Therapy Assistant (Licence: FL 25064) | |
| 225200000X Physical Therapy Assistant (Licence: NM A-1107) | |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2019-05-23 |