| NPI | 1972170769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13836) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-31794) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2025-07-03 |