| NPI | 1174166045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12184) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT30853) |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2021-08-04 |