| NPI | 1912555384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: NC P18997) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P18997) |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2022-09-02 |