| NPI | 1417540519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 99120700A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36003426A) |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2023-09-15 |