| NPI | 1629376413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: SD 0267) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MN A125) |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2011-03-03 |