| NPI | 1912217332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1206) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 6898) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2015-12-23 |