| NPI | 1023857208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65311) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OK 1240) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OR AT-AT-10243140) | |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-07-26 |