| NPI | 1912225335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT - 3463) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ID 070302361) |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2023-02-22 |