| NPI | 1821502261 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2087130) | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA21225) | 
| Enumeration Date | 2017-11-21 | 
| Last Update Date | 2017-11-21 |