| NPI | 1265098289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13068) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2023-05-30 |