| NPI | 1306453444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 052375) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: NC P21374) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2024-06-21 |