| NPI | 1750957890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 2154) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MN A1832) |
| Enumeration Date | 2021-05-30 |
| Last Update Date | 2021-05-30 |