| NPI | 1518249564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: AR PT3399) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AR 447) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2019-01-11 |