| NPI | 1639881410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MN 12951) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-12-23 |
| Last Update Date | 2023-02-13 |