| NPI | 1902359888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10294) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 10294) |
| 225100000X Physical Therapist (Licence: CO 0014281) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 2514) | |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2020-10-13 |