| NPI | 1962590612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 5011) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 15380) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2021-04-27 |