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 |