NPI | 1790199883 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: CO PTL.0014063) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-020768) |
225100000X Physical Therapist (Licence: CO PTL.0014063) | |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001579) | |
Enumeration Date | 2014-06-17 |
Last Update Date | 2022-09-29 |