| NPI | 1427166578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WA A1 60030256) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WA P1 60033055) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2011-01-28 |