| NPI | 1083159990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: SC 4941) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC SC530354) |
| Enumeration Date | 2017-01-01 |
| Last Update Date | 2022-10-11 |