| NPI | 1033827506 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT41749) | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36003487A) | 
| Enumeration Date | 2022-11-14 | 
| Last Update Date | 2025-02-12 |