| NPI | 1356742613 |
|---|---|
| Former Name | MARY KLASSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225500000X Specialist/Technologist (Licence: ID T178488) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: ID PTA-368) |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2014-09-05 |