| NPI | 1851782338 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WA P1 60040952) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WA P160040952) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2015-02-05 |