| NPI | 1144617622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.027442) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 070.027442) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2023-06-14 |