| NPI | 1972053163 |
|---|---|
| Former Name | SHAWNA ISRAEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT025622) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 291871) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA 2000013840) | |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2023-08-28 |