| NPI | 1699107722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9481) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 11713-024) |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2013-11-06 |