| NPI | 1861852741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 5030) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 014776) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT.003455) | |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2023-01-05 |