| NPI | 1457982290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13155) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 048588-01) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT297843) | |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2023-10-02 |