| NPI | 1750940102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11471) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 14741-24) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2020-06-01 |