| NPI | 1467014035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0018945) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT39866) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36003188A) | |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2023-05-12 |