| NPI | 1134798994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12503) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 4867) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2021-11-08 |