| NPI | 1609405380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT007809) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT032488) |
| Enumeration Date | 2020-04-05 |
| Last Update Date | 2024-08-06 |