| NPI | 1760830889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11031) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SD 1901) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2022-07-26 |