| NPI | 1093204935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE JT-0000956) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126002362) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2022-01-24 |