| NPI | 1346991205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI 5535) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 301237) |
| 225100000X Physical Therapist (Licence: AK 188339) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-10-28 |