| NPI | 1326504846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC 210002464) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305216535) |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2024-07-02 |