| NPI | 1093035198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-2413) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8483) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2010-06-11 |