| NPI | 1205385515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070026426) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096005502) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2023-02-05 |