| NPI | 1164029781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12010) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 12010) |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2021-04-02 |