| NPI | 1609333822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11909) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1314522) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MN 11909) | |
| Enumeration Date | 2019-02-24 |
| Last Update Date | 2023-01-09 |