| NPI | 1639855075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 30282) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 13171) |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2025-02-18 |