NPI | 1275899619 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT020630) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: PA RT000140A) |
Enumeration Date | 2012-04-10 |
Last Update Date | 2020-10-21 |