| NPI | 1992243596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10347) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 14920) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2020-05-18 |