| NPI | 1699200626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11429) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 11429) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2022-11-01 |