| NPI | 1891411617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12803) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA PTL27727) |
| 225100000X Physical Therapist (Licence: PA pt031402) | |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2026-02-27 |