NPI | 1144466798 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305205730) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: VA 0126001399) |
Enumeration Date | 2009-01-05 |
Last Update Date | 2012-03-11 |