| NPI | 1508275090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 1688) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8721) |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2014-08-08 |