| NPI | 1205277852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: OH 013751) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OH 003120) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2013-07-11 |