| NPI | 1295079440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 30466) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 9170) |
| Enumeration Date | 2012-11-11 |
| Last Update Date | 2020-01-29 |