| NPI | 1851645071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN MN9511) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12443-024) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2016-06-21 |