| NPI | 1467969576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY 0622) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT 13109) |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2019-11-06 |