| NPI | 1861750606 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: ID PTA-412) | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: UT 8255910-2402) | 
| Enumeration Date | 2012-04-30 | 
| Last Update Date | 2012-04-30 |