| NPI | 1649745159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2167) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11326) |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2022-01-04 |