| NPI | 1962955674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MI 5502007968) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: SC 3562) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2022-02-25 |