| NPI | 1912902461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 6700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 4940) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2016-07-08 |