| NPI | 1306143144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8983) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT013272) |
| 225100000X Physical Therapist (Licence: FL PT26642) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL2464) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT001852) | |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2018-09-05 |