| NPI | 1366051369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: VA 2306605581) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH PTA11772) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH 004444) | |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2024-03-28 |