| NPI | 1033731575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 5284) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0134693) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VT 104.0133973) | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2024-03-12 |