| NPI | 1003485566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH CP055070T) |
| 225100000X Physical Therapist (Licence: PA PT033837) | |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2026-04-14 |