| NPI | 1245067883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 14328) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0020030) |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2026-06-18 |