| NPI | 1720600240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14963) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11462) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-05-07 |