| NPI | 1255847760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 19558) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 11601) |
| 225100000X Physical Therapist (Licence: MN 11007) | |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2020-12-28 |