| NPI | 1760889778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9006) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12904) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2014-11-20 |