NPI | 1922467802 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 4558) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WV 2000005401) |
Enumeration Date | 2016-02-19 |
Last Update Date | 2016-02-19 |