| NPI | 1225531064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2018027217) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2018027218) |
| 225200000X Physical Therapy Assistant (Licence: IL 160007639) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096004237) | |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2022-01-25 |