| NPI | 1629166228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: CA PT16275) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT16275) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2025-09-11 |