| NPI | 1720335482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13841) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: CO 0011875) |
| Enumeration Date | 2012-08-12 |
| Last Update Date | 2025-08-11 |