| NPI | 1366735482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 8512) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60178685) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2021-03-11 |