| NPI | 1124586888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: FL PT41328) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT41328) |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2024-02-22 |