| NPI | 1770148280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-7045) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY PT-1862) |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2023-11-03 |