| NPI | 1073029260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 2305-19) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MN A2011) |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2017-12-26 |