| NPI | 1639470925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MN A1309) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2079261) |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2010-11-03 |