| NPI | 1194330753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT298726) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: 2000024479) |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2020-09-10 |