| NPI | 1689272684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014935) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: GA AT002969) |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-11-04 |