| NPI | 1750409157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IN 06003521A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KY AO2193) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: KY AT692) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2010-05-17 |