| NPI | 1386959807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 11587) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8492) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2017-03-23 |