| NPI | 1629046602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12766) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 10575) |
| 225100000X Physical Therapist (Licence: OR 5215) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2022-10-19 |