| NPI | 1609814003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1271) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 1605) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2007-10-01 |