| NPI | 1972907855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10202) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12925-24) |
| 225100000X Physical Therapist (Licence: FL 28453) | |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2021-08-25 |