| NPI | 1275189953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AK 148357) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11676) |
| Enumeration Date | 2019-08-17 |
| Last Update Date | 2023-02-08 |