| NPI | 1336587732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601001027) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501017884) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2017-04-02 |