| NPI | 1780992792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 006206) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8587) |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2021-04-28 |