| NPI | 1619360666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 4630) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0003690) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2020-09-29 |