| NPI | 1518927599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05004997A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36000446A) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2009-04-20 |