| NPI | 1154915601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12463) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 225100000X Physical Therapist | |
| 225100000X Physical Therapist (Licence: NC 23328) | |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2024-08-15 |