| NPI | 1972157063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MA 9615) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TEI005472) |
| Enumeration Date | 2019-07-28 |
| Last Update Date | 2019-07-28 |