| NPI | 1255107892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC CP031972T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305216542) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126004043) | |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2024-06-10 |