| NPI | 1386824365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10230) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-1339) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: MN 10230) | |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2018-04-11 |