| NPI | 1114659711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12622) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 16151) |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2022-11-21 |