| NPI | 1154929933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2020-10-13 |