| NPI | 1760626824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 160919) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VA 2306601297) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2013-10-09 |