| NPI | 1902329030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14339) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10780) |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2025-06-17 |