| NPI | 1982064473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 4209) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 080761) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2020-03-09 |