| NPI | 1356619464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: ID AT-495) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 3457) |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2024-06-21 |