| NPI | 1396747341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT001182A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE001655L) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00102900) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2025-09-11 |