| NPI | 1114457256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002481A) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2018-02-14 |