| NPI | 1770704306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 42268) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT18527) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL617) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2019-02-27 |