| NPI | 1639368111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2062079) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2007006870) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-19 |