| NPI | 1790205649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2128739) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WY 0927) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2017-06-21 |