| NPI | 1477951622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10997) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 036466) |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2018-03-17 |