| NPI | 1710357652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 3794) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 293332) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NV 0506510) | |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2021-11-09 |