| NPI | 1255454898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AZ 6046A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL 9463) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AZ 0401) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL 4649) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2007-07-08 |