| NPI | 1538306816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD 06223) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: MD 06223) |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2019-08-28 |