| NPI | 1972096519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY 1804) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ND 2087) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-12-20 |