| NPI | 1720437791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10276) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 4832) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2019-12-19 |