| NPI | 1215367412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10312) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 08599) |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2018-08-03 |