| NPI | 1558415315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: KS 14-00510) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KS 24-00078) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-07-08 |