| NPI | 1427687748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15165) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11930) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2021-06-28 |