| NPI | 1578529434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 060202027) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501012435) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2025-09-11 |