| NPI | 1710022652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 612) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 2115) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-07-08 |