| NPI | 1184133522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY 0942) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CO 0014239) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2018-01-04 |