| NPI | 1598478604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 17416-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 12232) |
| Enumeration Date | 2023-01-04 |
| Last Update Date | 2025-09-08 |