| NPI | 1851755441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014342A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 3154710319) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2021-08-27 |