| NPI | 1043323884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 4254) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-004254) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AZ 0206) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2024-05-20 |