| NPI | 1245848522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2297) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 12047) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2020-09-08 |