| NPI | 1497211650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 2600-19) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MI 5502005099) |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2019-02-13 |