| NPI | 1164147583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12764) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 101063) |
| Enumeration Date | 2022-10-07 |
| Last Update Date | 2022-10-07 |