| NPI | 1043572415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12994) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 3111995) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2023-10-03 |