| NPI | 1962110106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12889) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 65412) |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2025-01-24 |