| NPI | 1336890755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12506) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-32107) |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2023-10-11 |