| NPI | 1134866049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX AT5952) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT5952) | |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2022-05-13 |