| NPI | 1447801501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 097430) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11585) |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2019-09-20 |