| NPI | 1508234261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 09240) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MN A1956) |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2015-09-11 |