| NPI | 1447692900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 6698) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 10282-24) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2013-07-25 |