| NPI | 1124618780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MI 5502004871) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH PTA007775) |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2021-01-19 |