NPI | 1164496972 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT22425) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL 1979) |
Enumeration Date | 2006-02-16 |
Last Update Date | 2008-02-05 |