| NPI | 1225740418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13887) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 39701) |
| 225200000X Physical Therapy Assistant (Licence: FL 28461) | |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2026-02-26 |