| NPI | 1184019887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070026467) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05014365A) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002713A) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096005472) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2023-08-21 |