| NPI | 1760855605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10590) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 3494) |
| Enumeration Date | 2015-10-31 |
| Last Update Date | 2017-10-26 |