| NPI | 1710254214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 6702) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY PT-1431) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2018-03-17 |