| NPI | 1720536386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011752) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10503) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2025-02-25 |