| NPI | 1962950667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9959) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: MN 9959) |
| 225100000X Physical Therapist (Licence: ND 1732) | |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2017-03-16 |