| NPI | 1861129868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WA 61160809) |
| Enumeration Date | 2022-08-01 |
| Last Update Date | 2022-08-01 |