| NPI | 1720112105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2025617) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AR PTA 1434) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-07-08 |