| NPI | 1659425692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 938) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VA 2306605791) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2022-02-18 |