| NPI | 1447937842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216760) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P22425) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-3976) | |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2024-10-24 |