| NPI | 1992813117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 3650-024) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 5722) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2007-07-09 |