| NPI | 1891273066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 16222) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11104) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MN 11104) | |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2023-02-16 |