| NPI | 1518531003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 00000000) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2021-05-18 |