| NPI | 1720487028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-1724) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 12903) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2022-02-18 |