| NPI | 1235551243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 343-019) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MI 5502002565) |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2014-01-09 |