| NPI | 1730610544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070027302) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 12585) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2023-08-28 |