| NPI | 1104926237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 5992) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 0400003644) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2010-04-02 |