| NPI | 1265162242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12894) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-07052) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2023-03-09 |