| NPI | 1053729608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 4022) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-7569) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2015-04-22 |