| NPI | 1922683101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15626) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11942) |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2022-02-06 |