| NPI | 1811189376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: SD 0217) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WY PTA-195) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2007-08-17 |