| NPI | 1003389271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OH 1015) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH 5853) |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2019-01-09 |