| NPI | 1740495282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2006005751) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MO 2005004129) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2022-11-21 |