| NPI | 1710473749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 100755) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ND CP015501T) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2024-12-04 |