| NPI | 1932318409 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 19829) | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer | 
| Enumeration Date | 2007-05-22 | 
| Last Update Date | 2011-11-14 |