| NPI | 1376739821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 7771) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12207) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2020-08-20 |