| NPI | 1700113982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 8683) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1121507) |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2011-03-20 |