| NPI | 1790159218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: KS 14-00333) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NE 601) |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2015-11-20 |