| NPI | 1326634981 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: WA PT61061339)  | 
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: IL 070.025215)  | 
| Enumeration Date | 2020-12-17 | 
| Last Update Date | 2022-01-17 |