| NPI | 1790917334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NE 636) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IA 00649) |
| 225200000X Physical Therapy Assistant (Licence: SD 0134) | |
| Enumeration Date | 2009-08-16 |
| Last Update Date | 2009-08-16 |