| NPI | 1457088676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15678) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11918) |
| Enumeration Date | 2022-08-07 |
| Last Update Date | 2022-08-07 |