| NPI | 1508468935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 3126905) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT7138) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000027725) | |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2021-06-17 |