| NPI | 1912203316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 24414) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NJ 40QB00069600) |
| 225200000X Physical Therapy Assistant (Licence: NC 5216) | |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2016-03-29 |