| NPI | 1225429319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NC P17097) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: NC P087816) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC BOC252014) | |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2021-06-14 |