| NPI | 1376253856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9804) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12914-24) |
| Enumeration Date | 2022-11-25 |
| Last Update Date | 2025-09-19 |