| NPI | 1013980507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: IL 096-000761) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2015-03-13 |