| NPI | 1114650157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT42676) |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2025-02-10 |