| NPI | 1730626680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0000776) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CO PTA.0012631) |
| 225700000X Massage Therapist (Licence: CO MT.0008369) | |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2017-01-30 |