| NPI | 1699984013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 1434) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ND 280) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |