| NPI | 1992800551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1288) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 6503) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2022-03-04 |