| NPI | 1003924614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 7454) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SD 1290) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2022-03-09 |