| NPI | 1215612072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13066) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 65015) |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2026-03-05 |