| NPI | 1518485762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 008245) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 019380) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2022-06-14 |