| NPI | 1154467272 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 6512) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT8100) | 
| Enumeration Date | 2007-01-29 | 
| Last Update Date | 2007-07-08 |