| NPI | 1700126638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MN A1615) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MN 195019) |
| 225200000X Physical Therapy Assistant (Licence: WI 195019) | |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2022-02-15 |