| NPI | 1104904986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 4596) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT004261) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-01-22 |