| NPI | 1427591932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PHT10606) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AL 2087) |
| Enumeration Date | 2016-12-01 |
| Last Update Date | 2021-11-04 |