| NPI | 1134776677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT017987) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH10920) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: KY AT1605) | |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OH AT005284) | |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36003165A) | |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: AL 2689) | |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2023-01-11 |