NPI | 1568669398 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1458) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ND 297-05) |
Enumeration Date | 2007-06-27 |
Last Update Date | 2010-09-14 |