| NPI | 1619338274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MN TBD) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: IA 080345) |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2016-03-10 |