| NPI | 1396718060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: IN 05009744A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36001566A) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2012-10-15 |