| NPI | 1679922454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MD 5036) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OR 09299) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2021-09-08 |