| NPI | 1649770140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WY 0950) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH 011100) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2019-04-08 |