| NPI | 1154534980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 6295) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8045) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2019-11-19 |