| NPI | 1346633823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9975) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21581) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-10-15 |