| NPI | 1720434079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 6446) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8878) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2016-05-05 |