| NPI | 1952856445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT39736) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601002106) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2026-05-06 |