| NPI | 1689289662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-2192) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0016976) |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2023-03-14 |