| NPI | 1992118772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-1909) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-5997) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2019-09-28 |