| NPI | 1487209730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: AZ 31717) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: CA 296648) |
| 225100000X Physical Therapist (Licence: PA PT027727) | |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2022-01-21 |