| NPI | 1295162105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-1512) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY PT1512) |
| 225100000X Physical Therapist (Licence: WY 1512) | |
| Enumeration Date | 2013-10-09 |
| Last Update Date | 2018-11-06 |