| NPI | 1073533055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-0912) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 34191) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-06-09 |