| NPI | 1407250368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12917) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 9616) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2014-10-21 |