| 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 |