| NPI | 1487172508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0014952) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: CO AT.0001252) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2019-07-29 |