| NPI | 1124365028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: VA 0126000935) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: VA 0019007248) |
| 225700000X Massage Therapist (Licence: CA 70569) | |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2016-08-30 |