| NPI | 1952606568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 8678) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 6067-24) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |