| NPI | 1821465303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9595) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 1216424) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2015-08-31 |