| NPI | 1740704782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MN 4546) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 3029-19) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2021-06-27 |