NPI | 1518485762 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 008245) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 019380) |
2255A2300X Specialist/Technologist, Athletic Trainer | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-09-07 |
Last Update Date | 2022-06-14 |