| NPI | 1265864391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0001287) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 2118) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MD A0001287) | |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2021-09-10 |