| NPI | 1962926865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12523) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2017026837) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2022-05-02 |