| NPI | 1861930935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001355) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CO MT.0017978) |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CO MT.0017978) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CO AT.0001355) | |
| 2083S0010X Preventive Medicine, Sports Medicine (Licence: CO AT.0001355) | |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2020-11-09 |