NPI | 1528690260 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0019620) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-02-11 |
Last Update Date | 2024-02-21 |