| NPI | 1629499181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225800000X Recreation Therapist |
| Additional Taxonomies | 224Y00000X Clinical Exercise Physiologist |
| 2251S0007X Physical Therapist, Sports | |
| 246Z00000X Specialist/Technologist, Other | |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2014-10-18 |