| NPI | 1750766564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1953) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 9948) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2016-08-03 |