| NPI | 1962773374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 005198) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8496) |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2019-06-10 |