| NPI | 1144859414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX U6719) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2023-09-28 |