| NPI | 1538608195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 09452) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MN 1820) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2017-02-15 |