| NPI | 1649764101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0015624) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: CO PTL.0015624) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001205) | |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2022-03-17 |