| NPI | 1346327186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 105545) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 116418) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-05-01 |