| NPI | 1720434558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 29533) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: MA 23713) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA 2972) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD 1554) | |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2024-06-19 |