| NPI | 1053771410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05013501A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36002678A) |
| Enumeration Date | 2016-02-28 |
| Last Update Date | 2019-08-09 |