| NPI | 1811649072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12075) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID pending) |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2024-11-13 |