NPI | 1467680835 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 8324399-8016) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA 01997) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: UT 8324399-4810) | |
Enumeration Date | 2009-06-24 |
Last Update Date | 2018-12-08 |