NPI | 1790108397 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12532) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 20562) |
225100000X Physical Therapist (Licence: CA PT33160) | |
Enumeration Date | 2014-02-03 |
Last Update Date | 2022-01-20 |