| NPI | 1558918805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2606) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11678) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2022-03-04 |