| NPI | 1659756328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2462) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 4096) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2022-06-22 |