| NPI | 1063768240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12231-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 9043) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2013-10-17 |