| NPI | 1699582478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13243) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 4465) |
| Enumeration Date | 2024-12-16 |
| Last Update Date | 2024-12-16 |