| NPI | 1447650023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204353) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: VA 0126000598) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2017-03-01 |