| NPI | 1730815333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12767) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 64482) |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2022-07-26 |