| NPI | 1134661549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 4308) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NV 0506407) |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2022-10-24 |