| NPI | 1023615382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12041) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 15320) |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2023-05-17 |