| NPI | 1063744944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 8981) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 11145-24) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2020-09-10 |