| NPI | 1205377397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 042284) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22725) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA 2894) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NH 0628) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 002813) | |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2019-12-16 |