| NPI | 1548796832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10822) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IL 227017598) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2019-03-18 |