| NPI | 1750687315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MN A1512) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IA 001364) |
| 225200000X Physical Therapy Assistant (Licence: TX 2074749) | |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2014-04-30 |