| NPI | 1902150501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MT 2276) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AZ 9541A) |
| Enumeration Date | 2012-11-04 |
| Last Update Date | 2012-11-04 |