| NPI | 1770186678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13807) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 100945) |
| Enumeration Date | 2020-11-21 |
| Last Update Date | 2025-04-18 |