| 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 |