| NPI | 1043231665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WV 001257) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2009-09-16 |