| NPI | 1528219094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NY 032661) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305205605) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36001318A) | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2014-10-17 |