| NPI | 1972088565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 11173) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60885893) |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2019-09-18 |