| NPI | 1083647895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 4425) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501004033) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2022-03-07 |