| NPI | 1346767068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 041756) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 003368) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CT 001004) | |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |