| NPI | 1194377614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11671) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 4777) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2020-10-13 |