| NPI | 1619343589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8745) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10118) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2022-07-21 |