| NPI | 1992742985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 7655) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ND 852) |
| 225100000X Physical Therapist (Licence: MN 2156) | |
| 225100000X Physical Therapist (Licence: MI 5501008624) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2012-05-03 |