| NPI | 1528344199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 32848) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NJ 25MT00164000) |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2023-02-14 |