| NPI | 1093307423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13008) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2021004489) |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2025-12-05 |