| NPI | 1720126097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10397-024) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 7716) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2011-10-10 |