| NPI | 1699439687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12619) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 15494) |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2022-05-27 |