NPI | 1942489794 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-954) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: ID AT-077) |
Enumeration Date | 2007-10-29 |
Last Update Date | 2023-03-14 |