| NPI | 1326307414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305207372) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NC P13630) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 120602572) | |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2012-05-09 |