| NPI | 1467796607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11335) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60232224) |
| Enumeration Date | 2012-11-10 |
| Last Update Date | 2023-05-17 |