| NPI | 1679987945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0134913) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 5639) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2025-02-19 |