| NPI | 1104030915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1609) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 7916) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2021-02-18 |