| NPI | 1720611031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: LA A7726) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AZ PTA-010009) |
| Enumeration Date | 2020-02-14 |
| Last Update Date | 2020-02-14 |