NPI | 1184291627 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT40019) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL7088) |
225100000X Physical Therapist (Licence: MO 2021021918) | |
Enumeration Date | 2021-06-04 |
Last Update Date | 2024-12-20 |