| NPI | 1184998460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: FL 46583) |
| Additional Taxonomies | 225500000X Specialist/Technologist |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL 46583) | |
| Enumeration Date | 2012-03-03 |
| Last Update Date | 2012-03-03 |