| NPI | 1033689872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT004875) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE007980) |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2018-12-04 |