| NPI | 1770966947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 2129-19) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MN A1505) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-07 |