| NPI | 1891016739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 11672) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8505) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2011-05-02 |