| NPI | 1720418130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 1941) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: MN 9008) |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2018-03-17 |