| NPI | 1770643298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 0484) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 7915) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2022-03-04 |