| NPI | 1396287769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9046) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12910-24) |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2019-08-15 |