| NPI | 1679321384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 16843) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 13584) |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2024-07-12 |