| NPI | 1144749219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211461) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10847) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2017-09-11 |