| NPI | 1497793848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS 14-01637) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KS 24-00387) | |
| 225200000X Physical Therapy Assistant | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2016-07-13 |