| NPI | 1609264662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 1972) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OR 9121) |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2014-12-29 |