NPI | 1558907410 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 11732R) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: LA 339412) |
Enumeration Date | 2019-11-25 |
Last Update Date | 2024-03-18 |