| NPI | 1588430334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 10419) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: CO 0002397) |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2025-05-02 |