| NPI | 1720011992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: AZ 30870) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 8087) |
| 225100000X Physical Therapist (Licence: OH 11383) | |
| 2251S0007X Physical Therapist, Sports (Licence: NC P13199) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2021-09-17 |