| NPI | 1891996757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10996) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MN 5074) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2021-06-16 |