| NPI | 1710312707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10110) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 12366) |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2015-09-18 |