| NPI | 1851547103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AZ 7819A) |
| Additional Taxonomies | 261QA0900X Clinic/Center Amputee (Licence: AZ 454210419) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2012-01-26 |