| NPI | 1194295055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2019-10-31 |