| NPI | 1306336789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 35369) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL al4958) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2021-02-24 |