| NPI | 1477964377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1749) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: ND 425-11) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2023-06-19 |