| NPI | 1619314515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 098496) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 9306) |
| 225100000X Physical Therapist (Licence: MN 2974) | |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2022-07-07 |