| NPI | 1144600420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA TE012350) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126002538) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 2000020272) | |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2020-01-02 |