| NPI | 1760630313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IN 06001754A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36000474A) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2011-12-07 |