| NPI | 1508381351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT210002359) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 050309) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 004005) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-08-12 |
| Last Update Date | 2023-10-04 |