| NPI | 1407213879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: ND 0872) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: ND 076-90) |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2016-01-15 |