| NPI | 1750767596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: KS 14-01298) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2015026054) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2015-08-04 |