| NPI | 1215662291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13144) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT38963) |
| Enumeration Date | 2022-07-22 |
| Last Update Date | 2023-08-02 |