| NPI | 1558318592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-0964) |
| Additional Taxonomies | 174400000X Specialist (Licence: WY PT-0964) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2023-02-01 |