| NPI | 1841711389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA TEI002410) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MD A4185) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT003400) | |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2017-07-06 |