| NPI | 1801227236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11391) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2013040831) |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2021-10-04 |