| NPI | 1619309168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH 002963) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2013-08-07 |