| NPI | 1851815823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 36700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10783) |
| 225100000X Physical Therapist (Licence: MN 4531) | |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2021-02-10 |