| NPI | 1285778514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MI 5501004174) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2018-06-04 |