| NPI | 1598121725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070024015) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL M24011592870) |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2018-09-25 |