| NPI | 1174138101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: MO 2021034182) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002790A) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2021037359) | |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2023-08-09 |