| NPI | 1376735258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 8763) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 004078) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2011-09-08 |