| NPI | 1346518628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KS 24-00788) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: KS 24-00788) |
| 225700000X Massage Therapist (Licence: TX 36927) | |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-01 |