| NPI | 1164809588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P23202) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KY AT1267) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2024-08-08 |