| NPI | 1457325458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT19661) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT19661) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL1906) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2021-11-02 |