| NPI | 1982089702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 076568) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.022273) |
| 225100000X Physical Therapist (Licence: NC P17020) | |
| 225100000X Physical Therapist (Licence: TX 1300541) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 078780) | |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2020-02-14 |