| NPI | 1114598711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2397) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11992) |
| Enumeration Date | 2021-07-05 |
| Last Update Date | 2021-07-05 |