| NPI | 1477548824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC 446) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: SC 2026) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2025-09-11 |