| NPI | 1164803482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT026653) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT013320) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2021-10-21 |