| NPI | 1609502269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: IL 2000052348) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 2000052348) | |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2023-04-17 |