| NPI | 1700902517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 225700000X Massage Therapist | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2024-02-16 |