| NPI | 1538792585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT0004234) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH PTA011092) |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2020-02-26 |