| NPI | 1184167413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10604) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 13300 - 24) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2024-02-09 |