| NPI | 1508312836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT37561) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL A656281948320) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL4619) | |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2022-04-11 |