NPI | 1164159604 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT39156) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL5729) |
Enumeration Date | 2022-08-04 |
Last Update Date | 2022-08-10 |