| NPI | 1407587215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN PT14083) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT38933) |
| 225100000X Physical Therapist (Licence: PA PT030187) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT006003) | |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2026-05-18 |