| NPI | 1548908130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-5827) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC LAT-5827) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NC LAT-5827) | |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2024-11-05 |