| NPI | 1124100797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 21755) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 7768) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2022-01-05 |