| NPI | 1356721112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MN A1965) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MN 4063) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-08-07 |