| NPI | 1215162565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10973) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 11235-024) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2018-04-19 |