| NPI | 1023365822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 1943) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MN A1571) |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2019-01-31 |