| NPI | 1962976936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT2254) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0016161) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2023-03-22 |