| NPI | 1932766540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-07761) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS 14-03886) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2024-11-22 |