| NPI | 1497138770 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-033458) | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer | 
| Enumeration Date | 2015-07-03 | 
| Last Update Date | 2024-04-18 |