| NPI | 1871168005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2024033758) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC CP052036T) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 225100000X Physical Therapist (Licence: TX 1388720) | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2025-12-30 |