| NPI | 1366772170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-796) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: WY PT-796) |
| 2251P0200X Physical Therapist, Pediatrics | |
| Enumeration Date | 2009-12-30 |
| Last Update Date | 2009-12-30 |