| NPI | 1548676356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8684) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305208712) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126001707) | |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2018-10-02 |