| NPI | 1174028237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P21321) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2025-11-25 |