| NPI | 1891415733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14569-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 4565) |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2022-08-31 |