| NPI | 1922651074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NC TA6899) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VA 2306605279) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-18 |