| NPI | 1073963286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT1899) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 61738) |
| 225100000X Physical Therapist (Licence: ID PT-4460) | |
| Enumeration Date | 2016-06-18 |
| Last Update Date | 2020-08-06 |