| NPI | 1750539300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 6599) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 9125) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2020-02-03 |