| NPI | 1003282088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12953) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 13103-24) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2023-08-14 |