| NPI | 1770195174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15689-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0017205) |
| 225100000X Physical Therapist (Licence: MN 11950) | |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2024-03-15 |