| NPI | 1053680314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: DC 871323) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 23883) |
| 2251S0007X Physical Therapist Sports (Licence: VA 2305210021) | |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2024-02-28 |