| NPI | 1386395184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: WY PT-2130) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CO PTL.0018109) |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-01-12 |