| NPI | 1033567664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MN A1785) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: ND 1037) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |