| NPI | 1750420220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: SC r 83691) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: SC 1610) |
| 225200000X Physical Therapy Assistant (Licence: VA 2306601404) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |