| NPI | 1710317797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-1339) |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics (Licence: WY PT-1339) |
| 2251N0400X Physical Therapist Neurology (Licence: WY PT-1339) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: WY PT-1339) | |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2022-09-22 |