| NPI | 1912181009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: SC 5560) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: SC 5560) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2018-06-27 |