| NPI | 1588612659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0000360) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: DE J3-0000030) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2007-07-08 |