| NPI | 1609356302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: 2052263) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NE 648) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2018-08-21 |