| NPI | 1023132057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2005019093) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2004022186) |
| 225100000X Physical Therapist (Licence: CA PT 36445) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2014-05-09 |