| NPI | 1508231564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: IN 05011902A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002639A) |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2022-08-15 |