| NPI | 1558885780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: VA 2305211359) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MD 29274) |
| 2251S0007X Physical Therapist, Sports (Licence: DC 200001207) | |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2025-01-23 |