| NPI | 1437767662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 2229) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SD 2000029375) |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2022-09-28 |