| NPI | 1336590066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10326) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 14788-24) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2020-02-19 |