| NPI | 1316826191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 14099) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT-2025-0350) |
| Enumeration Date | 2025-08-27 |
| Last Update Date | 2026-01-12 |