| NPI | 1760980726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD CP039534T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH11158) |
| 225100000X Physical Therapist (Licence: WV PT004513) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2025-01-27 |