| NPI | 1477088367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11770) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01724300) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2020-09-24 |