| NPI | 1124471875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9538) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 13595) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2020-09-04 |