| NPI | 1356855159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: UT 10979488-4810) |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2020-02-07 |