| NPI | 1326447921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MN 9799) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MA 346536) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2018-08-21 |