NPI | 1689059586 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11594) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 13057-24) |
2251P0200X Physical Therapist, Pediatrics (Licence: MN 13057-24) | |
Enumeration Date | 2015-07-21 |
Last Update Date | 2020-10-13 |