| NPI | 1265907778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT42699) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL7356) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2025-01-09 |