| NPI | 1679085047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MT 13146) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AZ 11516A) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2017-10-25 |