| NPI | 1861883597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9848) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: MN 9848) |
| 172M00000X Mechanotherapist (Licence: GA PT012578) | |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2020-01-07 |