| NPI | 1225428873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OK 1205) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA 2000021465) |
| 225700000X Massage Therapist (Licence: CA 20318) | |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2021-04-19 |