| NPI | 1013495621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2018-08-06 |