| NPI | 1326177742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 15746) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P15746) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT 23589) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: SC 5611) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC 935) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL1773) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2023-11-21 |