| NPI | 1700622180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-08-02 |