| NPI | 1518096353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 62906) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OR 62906) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2023-08-25 |