| NPI | 1982256830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12874) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SD 2151) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2024-06-12 |