| NPI | 1619740297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 19975) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT007361) |
| 225100000X Physical Therapist (Licence: PA PT030886) | |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2024-09-18 |