| NPI | 1255738837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AL 1537) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AL 1537) |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2019-12-22 |