| NPI | 1134777246 |
|---|---|
| Former Name | SARA SELF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA pending) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2019-09-01 |
| Last Update Date | 2024-11-13 |