| NPI | 1518974112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN AT 440) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TN 5026) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-01-27 |