| NPI | 1639473051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211436) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI L1861455) |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2018-03-17 |