| NPI | 1306485826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 004496) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 012389) |
| 225200000X Physical Therapy Assistant (Licence: PA TE012375) | |
| Enumeration Date | 2020-01-01 |
| Last Update Date | 2022-10-11 |