| NPI | 1548284862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 8017) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: WI 6372-24) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2014-07-16 |