| NPI | 1043607021 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT37121)  | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer | 
| 225100000X Physical Therapist (Licence: FL 37121)  | |
| Enumeration Date | 2015-04-17 | 
| Last Update Date | 2025-04-03 |