| NPI | 1306204409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OR 2000017382) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OR 9957) |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2021-10-11 |