NPI | 1235692781 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15887-24) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
Enumeration Date | 2019-04-11 |
Last Update Date | 2022-09-23 |