| NPI | 1467825489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5501017854) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MI 2601001124) |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2018-10-03 |