| NPI | 1962621722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 8441) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WY PTA-559) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-07-08 |