| NPI | 1790296754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2150) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10948) |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2022-11-17 |