| NPI | 1336738541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: ND 174-97) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: ND 0875A) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-01-12 |