| NPI | 1275711798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA 27473) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL 4430) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.002224) | |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2017-05-05 |