| 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 |