NPI | 1467873489 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 224Y00000X Clinical Exercise Physiologist (Licence: AZ 042118) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AZ 7102651204) |
Enumeration Date | 2013-12-17 |
Last Update Date | 2013-12-17 |