| NPI | 1639180540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 29371) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2021-02-06 |