| NPI | 1679906085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 13325) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT023024) |
| 225100000X Physical Therapist (Licence: MN 10208) | |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2018-09-25 |