| NPI | 1073346375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 14362) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ND 2771) |
| Enumeration Date | 2024-08-22 |
| Last Update Date | 2026-06-15 |