| NPI | 1306329446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11303) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 093661) |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2023-08-11 |