| NPI | 1912640459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WA 61141442) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 51110) |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2022-04-18 |