| NPI | 1417111816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL-10528) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126002535) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT-794) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2024-04-01 |