| NPI | 1619680246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13615) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 5025) |
| Enumeration Date | 2022-12-28 |
| Last Update Date | 2024-12-09 |