| NPI | 1962974063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA 190337399) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MD A0509) |
| Enumeration Date | 2018-12-30 |
| Last Update Date | 2019-03-26 |