| NPI | 1760580682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 12091) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 6723) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2023-07-12 |