| NPI | 1801233622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MN A1374) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2077570) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2013-06-03 |