| NPI | 1255877924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NV 0506298) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NV 4935) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2022-08-08 |