| NPI | 1710670930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH11586) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 13018) |
| Enumeration Date | 2023-06-01 |
| Last Update Date | 2024-04-21 |