| NPI | 1457851644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Z00000X Orthotist (Licence: PA OH000353) |
| Additional Taxonomies | 224P00000X Prosthetist (Licence: PA PO000249) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: PA RTO000187) | |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2018-02-14 |