| NPI | 1821507062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13046) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI 5177) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305211533) | |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2023-09-12 |