| NPI | 1538556493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: DE J3-0000485) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MD 25845) |
| 225100000X Physical Therapist (Licence: DE J1-0003568) | |
| Enumeration Date | 2015-04-18 |
| Last Update Date | 2016-09-19 |