| NPI | 1861128084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12737) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 13737) |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2022-08-10 |