| NPI | 1679083190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9217) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 293674) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2021-12-02 |