| NPI | 1366080137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-1933) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0016684) |
| 225100000X Physical Therapist (Licence: NY 043459) | |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2022-03-23 |