| NPI | 1730634361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11434) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60663259) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2019-06-20 |