NPI | 1356847602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT017276) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 003914) |
Enumeration Date | 2018-04-04 |
Last Update Date | 2024-08-21 |