| NPI | 1306327200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT002506A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TEI005237) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2023-08-31 |