| NPI | 1639535651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 2357) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ND 0453) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |