| NPI | 1013473370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: LA A11651) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2025-12-29 |