| NPI | 1164172201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15952) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 12377) |
| 225100000X Physical Therapist (Licence: WI 22230) | |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2022-10-03 |