| NPI | 1962206623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12455) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 4674) |
| 225100000X Physical Therapist (Licence: TX 1368819) | |
| 225100000X Physical Therapist (Licence: IA 12252) | |
| Enumeration Date | 2025-04-02 |
| Last Update Date | 2025-04-02 |