| NPI | 1770528556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-1168) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT 1151PT) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2015-10-27 |