| NPI | 1821151044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: ID PTA386) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00022628) |
| 225200000X Physical Therapy Assistant (Licence: WA P160041285) | |
| 225700000X Massage Therapist (Licence: ID MAS2825) | |
| 225700000X Massage Therapist (Licence: AZ MT21298) | |
| 225200000X Physical Therapy Assistant (Licence: AZ 8776A) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2017-04-26 |