| NPI | 1639186471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1103589) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KS 2400358) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-12-12 |