| NPI | 1104352673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9032) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 1447) |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2017-05-03 |