| NPI | 1639129174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 0010783) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO 0001050) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2014-10-06 |