| NPI | 1306871165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 1164) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 6890) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-03-04 |