| NPI | 1306893177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MN 4570) |
| 2251S0007X Physical Therapist, Sports (Licence: MN 4570) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2022-07-01 |