| NPI | 1104505668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13050) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0019419) |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2025-12-01 |