| NPI | 1861023293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP034751T) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NE 1080) |
| 225100000X Physical Therapist (Licence: NE 4701) | |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2024-09-25 |