| NPI | 1588015408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 13502-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10300) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |