NPI | 1104610526 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13930) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 5227) |
Enumeration Date | 2025-04-09 |
Last Update Date | 2025-06-09 |