| NPI | 1164492161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: VT 040-002463) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VT 104-0000042) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2020-06-18 |