| NPI | 1235573312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 5-19) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MN A698) |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2013-04-19 |