| NPI | 1275790743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 8528) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 12073) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2020-08-11 |