| NPI | 1346809753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65300) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MN A2417) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2024-05-15 |