| NPI | 1750997524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 20974) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11843) |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2021-07-06 |