| NPI | 1417565540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11883) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 11883) |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2022-12-24 |