| NPI | 1023574233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 046560) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NY 003433-1) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2023-04-24 |