| NPI | 1053711671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12495) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 11112) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2023-06-19 |