| NPI | 1104696384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 15542) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MN 13293) |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-12-17 |